T14: Helping Boston Area Teens Overcome Substance Use

It’s always thought that substance use in teens is high, but their parents’ generation used at higher rates. At least that’s what the National Institute on Drug Abuse (NIDA) said in its 2017 Monitoring the Future survey, which reported that teenage substance use was at its lowest levels in more than 20 years.

But trends don’t tell the full story. Although substance use has gone down, it hasn’t gone away. NIDA’s report showed that nearly half of twelfth-grade students have tried drugs. Even more have consumed alcohol.

For some, those first times turn into second and third times. And, eventually, substance use can turn into substance misuse. Once someone crosses that threshold into misuse or dependence, it’s like many other mental health conditions: Compassionate support and services make all the difference.

Bridging a Gap in Care

Mental health specialist Lea Forster knows this all too well. About four years ago, as her team at Lahey Health Behavioral Services began a concerted effort to screen more adolescents for substance misuse, they found an unfortunate gap in care. Lots of young people needed help, but there weren’t enough local resources to help them. And the few resources available came with a waitlist many weeks long.

That’s when they came up with Team Fourteen (T14), a mental health program to help Boston area adolescents aged 12 to 25 and their families work through substance misuse concerns.

“We decided to design the kind of program we wished existed,” Forster said. “And that meant a family- and community-based program that had availability, without a long wait for treatment, and support for families without transportation.”

Thanks to a grant from The Peter and Elizabeth C. Tower Foundation, their plans to create an accessible and effective program came to fruition in 2016. Over the past two years, Forster and her colleagues at T14 have served more than 100 families through their 14-session therapy model.

“The model is called the Adolescent Community Reinforcement Approach,” she said. “It includes 10 sessions with the adolescent, two sessions with the caregiver and two joint family sessions.”

Going Beyond Traditional Talk Therapy

In the 14 sessions, which are usually held at the adolescents’ homes, families aren’t just getting traditional talk therapy and abstinence lectures. Rather, counselors listen and coach them through harm-reduction techniques.

“Research shows that, compared to traditional talk therapy, young people who receive this treatment use substances less, spend less time in jail and institutions, miss less work, and spend more time with their families,” Forster said. “And while it’s a short-term treatment of 14 sessions, you see the positive results continue long after that, instead of relapsing when treatment ends.”

Forster also notes that T14 teaches life skills, such as communication and problem-solving, to help young people thrive. Role play and goal-setting help the lessons stick.

“They learn about triggers and what needs are being met when they’re using substances,” she said. “And there’s a lot of education around how to try new things, how to find healthy alternatives to get those needs met without substances.”

Together with a group treatment option, also offered by T14, the program’s efforts have paid off for families as well as the state mental health system. T14’s group was recognized with an award for innovative mental health programming in June and surveys show progress in families served, specifically increases in self-reported happiness and positive gains in relationships with caregivers.

Substance Misuse in Teens: What to Look For

So how do families get involved in T14’s services? Essentially, it starts with a phone call from a concerned parent, teacher or caregiver who notices a few warning signs.

“Kids are really good at keeping things underground, so you might not necessarily see it or smell it, but there are a few red flags,” Forster said. Among those warning signs, according to Forster and the Partnership for Drug-Free Kids:

  • Slipping grades or getting in trouble in school
  • Withdrawal from activities or friends
  • Irritability or mood changes
  • Lack of motivation or inability to focus
  • Changes in hygiene or appearance

How Parents or Caregivers Can Help

If a caregiver senses that something’s not right, approach the topic with open ears and a genuine willingness to help.

“It’s important to start from a place of empathy,” Forster said. “Choose a time to speak with [your child] when they’re not under the influence, be curious, and do more listening than talking.”

Do you know an adolescent aged 12 to 25 on the North Shore who might benefit from Team Fourteen? Contact the team to learn if individual or group therapy is right for you and your child.


*The content on this website is for informational purposes only and is not medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.

MORE IN Live Well